What Sparks Change? How Can We End Poverty?

What inspires change? What has impact on policy? What really motivates us to do social good?

Here’s one story from my past that I’ll never forget.

In 1987, Dr. Paul Farmer and I and a few others helped start a group called Partners in Health[4] to provide access to quality health care to the poor. In the beginning, the majority of our work was centered in Haiti. Seven years later, in 1994, we set up a program in Carabayllo, a settlement on the outskirts of Lima, Peru.

We began our program in Peru because a good friend of ours -- Father Jack Roussin – said we must. He said the area needed a much stronger primary health system, and so we helped build a cadre of community health workers. Our organization there, Socios en Salud[4], worked to improve the health care of people in the community, employed 20 local young people, built a pharmacy, and then conducted a health assessment for the town.

Then Father Jack became ill. He started losing weight. I urged him to return to his home in Boston. When he finally did, tests revealed that his lungs were full of tuberculosis (TB). And it wasn’t any TB. It was multi drug-resistant TB (MDR-TB). His disease was resistant to the four major drugs used to treat TB. Soon after, Father Jack died.

We went back to Carabayllo and investigated. Why did he have drug-resistant TB? We found an alarming number of cases of MDR-TB. We did two things: First, we immediately started looking for supplies of the drugs that could treat TB cases we discovered. We gave those to patients, and to our great relief we were able to cure most of them. Second, we started to push for a global program to treat poor people everywhere suffering from drug-resistant TB.

We fought and fought. It took years, but we finally succeeded in helping to create a new global plan for tackling MDR-TB, and the World Health Organization[5] established guidelines for all countries on how to treat those with the disease. Today -- even though drug-resistant TB remains an incredibly difficult problem globally that deserves far more attention -- I am proud to say Peru is a global leader in fighting drug-resistant TB. And I’m also proud to say that Socios en Salud has become a major contributor to the health care of many, many Peruvians – 18 years after we started.

Change happened in this case because one person, Father Jack, witnessed social injustice and urged us to respond. It happened because he inspired me and many others at Partners in Health to act. That inspired still others. We didn’t give up. We were motivated by our core value that every person has the right to access health care.

Now, as World Bank Group president, my colleagues and I are motivated by another huge challenge: Ending extreme poverty by working with governments, civil society, the private sector, foundations, and people in impoverished communities, who have been caught for too long in dire circumstances.

The world has made great strides in the last 25 years, cutting the percentage of people living in absolute poverty in half, but we can do much more.